| BackgroundAt present, one of the important disease threat to human health was coronary heart disease(CHD),and the incidence and mortality of coronary heart disease had been high. At the same time,as the present one of the fastest growing incidence of the disease, the onset age of coronary heart disease was more and more young. For the complex lesions, undergoing percutancous coronary intervention(PCI) and coronary artery bypass grafting(CABG) after strict drug treatment was particularly effective.Because of the little operative trauma and the exact therapeutic effect to alleviate clinical symptoms, improve the quality of life and long-term prognosis, percutaneous coronary stent implantation(PCI) had gradually become the first method for the treatment of complex coronary artery lesions.And with the improvement of devices, the indications for PCI was gradually relaxed,More and more complex coronary artery lesions were classified as an indication for PCI.With the increase of the proportion of percutaneous coronary stent implantation(PCI) in the coronary heart disease, the development of postoperative pathological and in-stent restenosis( in-stent Restenosis, ISR) become a hot issue in the Department of Cardiology at present. The previous studies showed that:Because of the mechanism of elastic recoil, thrombosis, intimal hyperplasia, vascular remodeling and inflammatory response, 6 months after the percutaneous coronary angioplasty(PTCA), the restenosis rate was up to 30%-50%,and due to the restenosis, 20%-30% of the patients using the bare metal stent(BMS) accepted further treatment. The using of drug coated stents(DES) could reduced the incidence of restenosis, but it was still not less than 10%.It had become a hot topic in the field of cardiovascular intervention to explore the pathogenesis of ISR and to take targeted prevention. At the present of clinical intervention, it is also urgent to solve the problem of in-stent restenosis. ObjectiveThis study was to detect the changes of the serum levels of inflammatory cytokines Interleukin-8(Interleukin-8, IL-8) and Interleukin-18(Interleukin-18, IL-18) preoperative PCI, 24 hours after operation, 6 months after the operation.It was to investigate the role of inflammatory factors IL-8 and IL-18 in the in-stent restenosis after PCI,and in order to provide a more broad predictive value for the in-stent restenosis after PCI. MethodsIn the 232 patients with PCI, 172 patients were followed up for 6 months, and the 172 patients were selected as the selected objects.According to the result of CAG, the patients were divided into the restenosis group(group ISR) and the non-restenosis group(group NISR). Preoperative PCI, 24 hours after the operation, 6 months after the operation,all the selected subjects were drawn 2-4ml blood from the peripheral vein to detect the levels of Interleukin-8 and Interleukin-18 in plasma. Results 1. There was no significant difference in clinical data between the two group(P>0.05), such as sex, age, blood pressure, blood glucose, blood lipid, smoking history, and so on. 2. There was no significant difference in the plasma levels of Interleukin-8 and Interleukin-18 between the ISR group and the NISR group(P>0.05). 3. In the ISR group,there was a higher plasma levels of Interleukin-8 and Interleukin-18 than the NISR group after 24 hours and 6 months(P<0.01). 4. In the ISR group,the plasma levels of Interleukin-8 and Interleukin-18 after operation showed an upward trend, 24 hours and 6 months after the operation were higher than before the operation, 6 months after the operation was higher than 24 hours after the operation(all P<0.01). 5. In the NISR group, 24 hours and 6 months after the operation, the plasma levels of Interleukin-8 and Interleukin-18 was significantly higher than that before the operation. There was a decrease in 6 months after the operation, but it was still higher than that before the operation, and there was a significant difference(P<0.05). ConclusionAs the inflammatory mediators, Interleukin-8 and Interleukin-18 may be involved the whole process of restenosis after PCI, which can be used as a predictor of in-stent Restenosis. In clinical practice, the expression levels of Interleukin-8 and Interleukin-18 which were monitored regularly had a very good predictive value to jude the in-stent Restenosis. |
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